Insurance Approval ?!

[ladycharizar 44]

Ugh , sorry my auto correct is just the worst. And I'll try again, she's just really busy, I actually haven't seen my surgeon since the first initial meeting I've had with him.

[JT2002TJ 170]

1 minute ago, ladycharizar said:

Ugh , sorry my auto correct is just the worst. And I'll try again, she's just really busy, I actually haven't seen my surgeon since the first initial meeting I've had with him.

Oh, yeah, I haven't seen my surgeon since the initial consult. But I have been to the office for each of my weigh ins, so they see me all the time. Whenever I go there I give an updated checklist I created to my coordinator. I created a table in word with:

Description, Dr, Phone #, Scheduled Date, Scheduled Time, Location and Complete.

In this table I have all 20 items I needed to complete (PCP/Pulmonologist/Psych Consult/Support Group Meetings/Cardiology Consult/Upper Endoscopy/...), I put a check mark in the complete column so she knows where I am, what I have left, and who to contact to follow up of additional information is needed.

Because she now expects this from me, I get to have a short conversation with her every month as I give her the updated printout.

[ladycharizar 44]

Oh your more thorough I suppose, I knew I finished all my other appointments and the only thing left was my nutritionist appointment. So now that leads me to the dreaded wait for my insurance but I'll wait even though I'm super anxious.

[Ready4theday 35]

I suggest calling your coordinator and asking if the weight loss was an insurance requirement or a surgical group/hospital requirement. I have a feeling it will be the latter.
The medical industry is so much tied to patient outcomes. Surgeons really care about their complication rate, as it is what drives patients to them, and what determines future employment. This is why they put restrictions on smoking, it has nothing to do with the insurance companies, just complication rates.
If this is the case, it will be up to the surgeon. If they do approve they may warn you that if they even see the slightest issue doing it laparoscopically, they will open you up. The problem with higher BMIs is that the liver is bigger, which makes access to one's stomach more difficult.
I am not trying to worry you. Your best bet is to schedule a quick call with your coordinator, and have a list of questions written down and ready (they are busy, and may try to rush you out of workload not that they are dismissing you).

I've worked in healthcare for nearly 14 years and am now on the corporate side. You're right on point with this - It's all about outcomes. My insurance company (Cigna) only requires that I don't gain any weight above what I weighed on my initial consult. Other than that, no weight restrictions from the hospital or practice. I'm having surgery with the company that I work for, by the way.

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[JT2002TJ 170]

17 hours ago, Ready4theday said:

I've worked in healthcare for nearly 14 years and am now on the corporate side. You're right on point with this - It's all about outcomes. My insurance company (Cigna) only requires that I don't gain any weight above what I weighed on my initial consult. Other than that, no weight restrictions from the hospital or practice. I'm having surgery with the company that I work for, by the way.

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I also work in health care, in quality. I do data analytics (basically build systems/reports), with quality and regulatory data. EVERYTHING is about volume and complication rates.

I love where I work, but live too far away (38 miles from my house) to get the procedure done at work. So I found a group that has offices <5 miles from my house and <10 miles from my office. I was lucky to find a group with two offices, both close to where I spend most of my time.

I'm almost through this, I have my cardiology consult tomorrow, 4th weigh in in two weeks, final weigh in and then the waiting begins.

[Ready4theday 35]

I also work in health care, in quality. I do data analytics (basically build systems/reports), with quality and regulatory data. EVERYTHING is about volume and complication rates.
I love where I work, but live too far away (38 miles from my house) to get the procedure done at work. So I found a group that has offices I'm almost through this, I have my cardiology consult tomorrow, 4th weigh in in two weeks, final weigh in and then the waiting begins.

I don't blame you for having your surgery closer to home! Even if you're only in the hospital 1 night, who wants that long car ride the day after surgery?
I have my final NUT appt on the 31st and that's all. I met all other requirements by June 26th, so the waiting is frustrating - especially since it's just red tape. There's no reason they wouldn't clear me. But at least I get to go on vacation before I have to start my pre-op diet. The hardest part will be not gaining any weight! [emoji51]

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[JT2002TJ 170]

1 minute ago, Ready4theday said:

I don't blame you for having your surgery closer to home! Even if you're only in the hospital 1 night, who wants that long car ride the day after surgery?
I have my final NUT appt on the 31st and that's all. I met all other requirements by June 26th, so the waiting is frustrating - especially since it's just red tape. There's no reason they wouldn't clear me. But at least I get to go on vacation before I have to start my pre-op diet. The hardest part will be not gaining any weight!

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That would be hard for me too!!!